title: 50th Anniversary of the first successful permanent pacemaker implantation in the United States: historical review and future directions.
abstract: June 2010 marks the 50th anniversary of the first successful human cardiac pacemaker implantation in the United States. On June 6, 1960, in Buffalo, New York, Dr. William Chardack implanted a pacemaker, designed and built by Wilson Greatbatch, an electrical engineer and inventor, in a 77-year old man with complete atrioventricular block, extending the patient's life by 18 months. This landmark event ushered in a new era of implantable cardiac pacemakers with batteries and leads of high reliability and increasing durability. Over the past half century, the field of electrophysiology and implantable devices for the management of cardiac conduction disturbances has evolved dramatically. Today's pacemakers include increasingly complex features such as telemetry monitoring, auto programmability, and hemodynamic sensors. New-generation leads present a sophisticated design with improved geometry and steroid-eluting tips to reduce chronic inflammation, maintaining a low pacing threshold and high sensing capability. The lithium iodide battery remains the mainstay of implantable pacemaker systems, exhibiting a multiple-year lifespan, slow terminal decay, and a reduced size and cost of production. Although Greatbatch's first successful pacemaker implantation remains a seminal scientific contribution to modern cardiovascular disease management, emerging developments in this field may challenge its preeminence. Important challenges such as imaging compatibility, lead durability, and infection prevention are being addressed. Novel concepts such as leadless and biologic pacing are under active investigation. In conclusion, Greatbatch's historic achievement 50 years ago reminds us that technologic progress is timeless, as efforts to enhance clinical outcomes and the quality of life continue unimpeded into the 21st century.
authors.affiliation: University at Buffalo School of Medicine & Biomedical Sciences, Buffalo, New York, USA.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Beck
authors.forename: William E
authors.initials: WE
authors.lastname: Boden
authors.forename: Sushmitha
authors.initials: S
authors.lastname: Patibandla
authors.forename: Dmitriy
authors.initials: D
authors.lastname: Kireyev
authors.forename: Vipul
authors.initials: V
authors.lastname: Gutpa
authors.forename: Franklin
authors.initials: F
authors.lastname: Campagna
authors.forename: Michael E
authors.initials: ME
authors.lastname: Cain
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Marine
mesh_terms: D054537:Atrioventricular Block / Q000628:therapy*; D000075202:Contraindications; D011211:Electric Power Supplies; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008279:Magnetic Resonance Imaging; D010138:Pacemaker, Artificial / Q000266:history*; D019919:Prosthesis Implantation; D013686:Telemetry / Q000266:history / Q000379:methods